Enhanced Liver Fibrosis (ELF) Test

ELF™ is a non-invasive test to assess fibrosis in liver and metabolic diseases

The ELF score

The ELF score has been well-validated against biopsy-proven fibrosis across a range of chronic liver diseases (CLD) in both adult and pediatric populations. The three direct markers of the ELF test provide complementary information, and the combined score outperforms both the individual markers and simple scores such as APRI or FIB-4.​

The performance of the ELF test for liver fibrosis has been well-established in the scientific literature, and ease of testing and interpretation support routine clinical use as an alternative to invasive biopsy.​

Publications

The ELF™ scoring system

The Enhanced Liver Fibrosis (ELF™) test is a noninvasive blood (serum) lab test designed to assess levels of three major components directly involved in liver matrix metabolism: hyaluronic acid (HA), procollagen III aminoterminal peptide (PIIINP), and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1).

The analytes are automatically measured, and the software calculates and reports a unitless numeric score. Increasing ELF scores are linked to both biopsy-proven fibrosis and prognosis for clinically significant outcomes (Figure 1).

Figure 1. The ELF™ scoring system


Test specifications and laboratory capabilities

Test specifications

  • In-vitro diagnostic multivariate index Assay, FDA granted De Novo Marketing Authorization​
  • Serum-based assay available at Nordic in the high-throughput Attelica IM® System, under a CAP certified Lab and and enrolled in proficiency testing (PT) program ​
  • Volume required: 271 µl Can be run in the same aliquot as PRO-C3, using a combined volume of 362 µl​
  • Sample Stability: stable at ≤ -20°C for up to 12 months. Stable at ≤ -70C for three years, according to literature

Laboratory capabilities​

  • Bi-weekly testing frequency​
  • ​Batch-testing and on-demand testing available​
  • ​Turn-around time up to three working days*
  • Reported as Data transfer, Remote Lab-integration (RLI) or as individual Lab reports*
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